Vaccine hesitancy and equity: lessons learned from the past and how they affect the COVID-19 countermeasure in Indonesia

Vaccine hesitancy and equity: lessons learned from the past and how they affect the COVID-19 countermeasure in Indonesia

2024 | Rano K. Sinuraya, Rina F. Nuwarda, Maarten J. Postma, and Auliya A. Suwantika
Vaccine hesitancy and equity are critical issues affecting the COVID-19 response in Indonesia. Despite progress in increasing vaccine coverage, equitable access remains a challenge, especially in remote areas. The National Immunization Program (NIP) has not met WHO and UNICEF targets, with childhood immunization decreasing during the pandemic. Vaccine hesitancy has slowed pandemic efforts, increasing infection risks and negatively impacting the global economy. Indonesia's vaccination target is 234,666,020 individuals, or at least 70% of the population. The initial phase of vaccination involves Sinovac in two doses, followed by booster shots with AstraZeneca, Pfizer-BioNTech, Moderna, or Sinopharm. Vaccine hesitancy is influenced by factors such as lack of trust in vaccines, misinformation, cultural beliefs, and past negative experiences. It is crucial to understand the specific drivers of hesitancy in each country and population to overcome it. Collaborating with community or religious leaders, healthcare providers, and influencers can increase awareness and trust, reducing hesitancy. Vaccine hesitancy and inequity are closely related, with the potential to significantly influence each other. The 3Cs model (complacency, convenience, confidence) and the 5Cs model (confidence, complacency, constraints, calculation, collective responsibility) are used to analyze vaccine hesitancy. Misinformation and conspiracy theories are critical drivers of hesitancy, leading to fear and skepticism about vaccination. In Indonesia, concerns about vaccine safety, adverse effects, and non-halal ingredients have contributed to hesitancy. Socioeconomic factors such as low income, education levels, and limited healthcare access also influence hesitancy. Vaccine hesitancy in low-, middle-, and high-income countries is influenced by socio-economic and demographic variables. In Indonesia, vaccine hesitancy is a multifaceted problem requiring tailored and collaborative efforts. The national vaccination target for measles and rubella (MR) immunization varies widely among districts, with some reporting coverage rates below the established threshold. The hesitancy to receive the COVID-19 vaccine is highly correlated with socio-demographic characteristics, including age, location, education, employment, and family economic situation. The impact of vaccine hesitancy on the COVID-19 pandemic is significant, slowing progress toward herd immunity, increasing infection risks, and affecting the global economy. Vaccine hesitancy can lead to unfilled appointments and wasted doses, particularly for mRNA vaccines requiring ultra-cold storage. It can also burden the healthcare system, increasing costs due to ongoing hospitalizations and treatment for COVID-19 patients. Indonesia has faced a severe COVID-19 crisis since early 2020, with high case numbers and deaths. Despite efforts to address vaccine hesitancy through public awareness campaigns, vaccination coverage remains relatively low. The low vaccination rate has resulted in many cases andVaccine hesitancy and equity are critical issues affecting the COVID-19 response in Indonesia. Despite progress in increasing vaccine coverage, equitable access remains a challenge, especially in remote areas. The National Immunization Program (NIP) has not met WHO and UNICEF targets, with childhood immunization decreasing during the pandemic. Vaccine hesitancy has slowed pandemic efforts, increasing infection risks and negatively impacting the global economy. Indonesia's vaccination target is 234,666,020 individuals, or at least 70% of the population. The initial phase of vaccination involves Sinovac in two doses, followed by booster shots with AstraZeneca, Pfizer-BioNTech, Moderna, or Sinopharm. Vaccine hesitancy is influenced by factors such as lack of trust in vaccines, misinformation, cultural beliefs, and past negative experiences. It is crucial to understand the specific drivers of hesitancy in each country and population to overcome it. Collaborating with community or religious leaders, healthcare providers, and influencers can increase awareness and trust, reducing hesitancy. Vaccine hesitancy and inequity are closely related, with the potential to significantly influence each other. The 3Cs model (complacency, convenience, confidence) and the 5Cs model (confidence, complacency, constraints, calculation, collective responsibility) are used to analyze vaccine hesitancy. Misinformation and conspiracy theories are critical drivers of hesitancy, leading to fear and skepticism about vaccination. In Indonesia, concerns about vaccine safety, adverse effects, and non-halal ingredients have contributed to hesitancy. Socioeconomic factors such as low income, education levels, and limited healthcare access also influence hesitancy. Vaccine hesitancy in low-, middle-, and high-income countries is influenced by socio-economic and demographic variables. In Indonesia, vaccine hesitancy is a multifaceted problem requiring tailored and collaborative efforts. The national vaccination target for measles and rubella (MR) immunization varies widely among districts, with some reporting coverage rates below the established threshold. The hesitancy to receive the COVID-19 vaccine is highly correlated with socio-demographic characteristics, including age, location, education, employment, and family economic situation. The impact of vaccine hesitancy on the COVID-19 pandemic is significant, slowing progress toward herd immunity, increasing infection risks, and affecting the global economy. Vaccine hesitancy can lead to unfilled appointments and wasted doses, particularly for mRNA vaccines requiring ultra-cold storage. It can also burden the healthcare system, increasing costs due to ongoing hospitalizations and treatment for COVID-19 patients. Indonesia has faced a severe COVID-19 crisis since early 2020, with high case numbers and deaths. Despite efforts to address vaccine hesitancy through public awareness campaigns, vaccination coverage remains relatively low. The low vaccination rate has resulted in many cases and
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